Reliability of bimanual pelvic examinations performed in emergency departments

Objective To test the reliability of bimanual pelvic examinations performed in emergency departments by emergency medicine physicians. Design Prospect ive observational study; 2 examiners each recorded various pelvic examinati on findings on 186 patients. Setting A private university hospital and a pu blic county hospital staffed by attending emergency medicine physicians who share an emergency medicine residency program. Subjects Senior resident (3 rd or 4th year) and attending emergency physicians. 0 Main outcome measures Percentage of agreement and percentage of positive agreement for cervical motion tenderness, uterine tenderness, adnexal tenderness, adnexal mass, an d uterine size (within 2 cm). Results The agreement ranged between 71% and 84%, but the percentage of positive agreement was much lower, ranging from 17% to 33%. Agreement for uterine size, within 2 cm, was 60%. Conclusion Th e findings of bimanual pelvic examinations performed by emergency physician s in an emergency department have poor interexaminer reliability.